| 引用本文:王 月1 张 硕2 武 忠1 郭利平3.参附注射液用于围手术期的系统评价及Meta分析[J].世界中医药,2014,9(12):. |
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| 参附注射液用于围手术期的系统评价及Meta分析 |
| Systematic Review and Meta-analysis of Randomized Clinical Trials on Shenfu Injection used for Perioperative Period |
| 投稿时间：2014-03-19 |
| DOI：10.3969/j.issn.1673-7202.2014.12.016 |
| 中文关键词: 参附注射液 围手术期 随机对照试验 系统评价 Meta分析 |
| English Keywords:Shenfu Injection Perioperative Randomized clinical trials Systematic review Meta analysis |
| 基金项目: |
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| 中文摘要: |
| 目的：评价围手术期应用参附注射液的疗效及安全性。方法：计算机检索中国医学文献数据库(CBMdisc)、中国期刊全文数据库(CNKI)、万方数据库、维普数据库（VIP）数据库，并手工检索相关杂志，全面搜集参附注射液用于围手术期的随机对照研究文献，按照Cochrane协作网等推荐的方法评价纳入研究的方法学质量和提取有效数据后，应用RevMan5软件对纳入文献进行汇总分析。结果：符合纳入标准的文献共18篇，共计1 324例，其研究质量均为C级。Meta分析结果显示：在常规基础上加用参附注射液对围术期患者的影响如下：改善麻醉期间血流动力学（SBP［WMD＝-18.74，95%CI（-21.26，-16.23），P<0.000 01］、DBP［WMD＝-8.41，95%CI（-10.44，-6.37），P<0.000 01］、HR［WMD＝-10.59，95%CI（-12.50，-8.68），P<0.000 01］）、升高β-内啡肽［WMD＝28.93，95%CI（22.13，35.73），P<0.000 01］、促进麻醉催醒（拔管时间［WMD＝-9.62，95%CI（-11.61，-7.64），P<0.000 01］、离开ICU时间［WMD＝-17.06，95%CI（-22.06，-12.06），P<0.000 01］）、促进术后恢复（拔管时间［WMD＝-2.77，95%CI（-3.02，-2.53），P<0.000 01］、离开ICU时间［WMD＝-11.26，95%CI（-15.17，-7.35），P<0.000 01］），与单用常规相比差异有统计学意义。结论：参附注射液能够通过维持循环稳定等方面来对抗麻醉等围术期的不良刺激，并能促进术后恢复，在整个围术期起到保护性作用，效果优于单用西医常规。此结论尚有待于更多高质量临床试验来进一步验证。 |
| English Summary: |
| To evaluate the effectiveness and safety of Shenfu Injection used in perioperative period.Methods:Four electronic literature databases including CNKI，Wanfang Data，VIP，and SinoMed were searched to identify eligible randomized clinical trials on ShenFu used for perioperative period，and some relevant Chinese journals were also hand-searched for potentially eligible clinical studies.The quality of included studies was assessed against entries of the risk of bias table as recommended in the Cochrane handbook，and the data was analyzed using RevMan.Results:A total amount of eighteen studies involving 1 324 patients met the inclusion criteria for this review，and the quality of these studies were C level.Meta-analysis showed following Results:Shenfu injection combined with routine Western medicine has better effect on perioperative period in maintaining the stability of circulation（SBP［WMD =-18.74，95%CI（-21.26，-16.23），P<0.000 01］，DBP［WMD =-8.41，95%CI（-10.44，-6.37）P<0.000 01，HR［WMD =-10.59，95%CI（-12.50，-8.68），P<0.000 01］），elevating β-endorphin［WMD =28.93，95%CI（22.13，35.73），P<0.000 01］，promoting anesthesia wake-up including shortening the time of extubation［WMD =-9.62，95%CI（-11.61，-7.64），P<0.000 01］and leaving the ICU［WMD =-17.06，95%CI（-22.06，-12.06），P<0.000 01］），promoting the recovery after operation including shortening the time of extubation［WMD =-2.77，95%CI（-3.02，-2.53），P<0.000 01］and leaving the ICU［WMD =-11.26，95%CI（-15.17，-7.35），P<0.000 01］）.There was statistically significant difference compared with the pure western medicine treatment.Conclusion:Shenfu injection plays a protective role in the perioperative period，which can be against the perioperative adverse stimuli by maintaining the stability of circulation，and promote the recovery after operation.It is better than the pure western medicine treatment.This conclusion still needs more high quality clinical trials to further verify. |
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